14 Common SSRI Side Effects
Selective serotonin reuptake inhibitors (SSRIs) are generally a class of medication that can be commonly prescribed to manage the symptoms of depression and other mental health disorders, including obsessive-compulsive disorder, post-traumatic stress disorder, eating disorders, and anxiety. SSRIs are often widely utilized because their side effects are typically believed to be less severe than those associated with other types of antidepressants. However, SSRIs can still produce a range of side effects that you’ll likely want to be aware of if they’re part of your treatment plan. These can include weight gain, drowsiness, tremors, anxiety, mania, and more. Please be sure to discuss all questions regarding medication with your doctor, and never start or stop any form of medication without the guidance of a licensed medical professional. As medication tends to be most effective when combined with therapy, you may also wish to connect with a therapist in person or online.
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Potential SSRI side effects
As with nearly all types of medications, SSRIs can come with side effects. Below, you can learn more about many of the most common ones.
Please inform your doctor or psychiatrist if you experience any of the following.
1. Sexual dysfunction
One of the most common SSRI side effects can be sexual dysfunction, which can take many forms. Some have reported erectile dysfunction and an inability to ejaculate. Decreased libido can also occur. In some cases, this side effect can lead to tension in relationships and discomfort for the individual taking the medication.
2. Weight gain
Fluctuations in weight can be another common side effect of SSRIs. Many people report initial weight loss after starting SSRIs, followed by weight gain within six months of starting the medication, with additional weight gain sometimes following.
Changes in appetite are often to blame for the weight gain. Gaining weight can lead to additional physical health concerns, such as heart disease, high blood pressure, and diabetes.
3. Insomnia
Sleep disruptions are a potential SSRI side effect that can seriously impact an individual’s mental and physical health. Many people who take SSRIs experience trouble falling and staying asleep.
4. Emotional detachment
Many people struggle to experience emotions as strongly as usual when taking SSRIs. This side effect, commonly called emotional blunting, is thought to be related to higher medication doses, though it can occur regardless of the amount taken.
This side effect of SSRIs can be concerning for many people as they may not experience emotions like happiness or excitement in the way they normally do. Emotional detachment may also make it difficult to have an outlet for anxiety, sadness, or anger. While these feelings in the extreme may not be desirable, not feeling them at all can cause conflicts in relationships and decreases in overall quality of life.
5. Drowsiness
Fatigue and brain fog can be common side effects of SSRIs, and they often make it hard to concentrate and get as much done throughout the day. This drowsiness is thought to be caused by increased melatonin production. To alleviate feelings of drowsiness that can be caused by SSRIs, many professionals recommend sticking to a consistent sleep schedule, exercising regularly, and eating a balanced diet.
6. Anxiety
Some people have reported increased anxiety with the use of SSRIs. Though these medications are sometimes prescribed to manage anxiety, individuals may still begin to experience extreme feelings of worry or fear. These feelings are typically situational. The anxiety may also be related to emotional detachment, with anxiety potentially peaking because other feelings may not feel the same as they usually do.
There may be several lifestyle changes you can make to manage feelings of anxiety. Regularly practicing mindfulness, meditation, and deep breathing can reduce these symptoms. You may also consider reducing alcohol and caffeine consumption, as both substances can increase anxiety levels.
7. Restlessness
One of the more common SSRI side effects can be an increase in energy levels that may make it hard to sit still and relax. Without an outlet to expend this energy, an individual may feel restless while sitting for long periods, such as at work or school. They may also find themselves fidgeting more or frequently pacing when they are not engaged with the task at hand.
Feelings of restlessness may be reduced by finding healthy outlets for your energy. Remaining engaged in active pursuits can help you utilize your excess energy in a constructive way. You might consider starting a new hobby or volunteering with a local organization.
8. Agitation
Some people who take SSRIs find that they become more irritable than usual. Because SSRIs usually affect serotonin levels in the brain, an individual may become agitated easily, have little patience, or experience angry outbursts. Anger management techniques, such as deep breathing and grounding exercises, as well as support groups, can be helpful.
9. Tremor
Some people who take SSRIs for an extended period can develop involuntary muscle movements. Tremors may show up in any part of the body, but they are most often experienced in the hands. Some people develop a tremor so severe that it can become difficult to write with a pen or type on a computer.
10. Mania
When used for the treatment of depression in people with bipolar disorder or other personality disorders, SSRI side effects can cause or precipitate manic episodes. Manic episodes can be defined as periods in which an individual experiences an increase in energy, an elevated mood, and a decreased need for sleep. This can lead them to engage in risky behavior and experience potentially harmful physical symptoms. Starting an SSRI medication during a depressive episode in an individual with bipolar disorder can also cause a mixed episode, which can be dangerous. Please contact your doctor immediately if you experience this side effect.
Other physical side effects of SSRIs
Several other physical SSRI side effects have been reported on occasion. These side effects are frequently mild and tend to resolve themselves after treatment is continued for several weeks. However, these SSRI side effects can be common when starting treatment.
- Blurred vision
- Dry mouth
- Diarrhea
- Headache
Managing mental health conditions with therapy
Research generally supports the idea that the most effective treatment for depression is typically a combination of therapy and medication. Meanwhile, the most effective treatment for anxiety is usually psychotherapy. Other mental health disorders can also be effectively treated with in-person or online therapy.
Benefits of online therapy
With an online therapy platform like BetterHelp, you can participate in sessions remotely, which can be helpful if you’re struggling to leave home due to mental health disorder symptoms or medication side effects. In addition, you can schedule sessions that fit into your life, as there are often timeslots available outside of typical office hours.
Effectiveness of online therapy
A growing body of evidence suggests that online therapy can help individuals manage symptoms of mental health disorders that are commonly treated with SSRIs. For example, in one study, researchers concluded that online cognitive behavioral therapy could produce “sustained and clinically meaningful improvements in depression and anxiety” for those experiencing moderate to severe symptoms. Cognitive behavioral therapy can be a common treatment method that usually helps the individual identify and replace negative thought patterns that may be underlying maladaptive behaviors and emotions, such as those related to depression.
Takeaway
How long does it take for your body to get used to SSRI?
The time it takes for your body to adjust to SSRI (Selective Serotonin Reuptake Inhibitor) medications can vary from person to person. However, here's a general timeline for what you might expect:
- Initial Weeks: In the first few days to weeks after starting an SSRI, you may experience some side effects, which can include nausea, dizziness, insomnia, and increased anxiety. These side effects are typically temporary and often improve within the first two weeks.
- Therapeutic Effects: The therapeutic effects of SSRIs, such as a reduction in symptoms of depression or anxiety, usually begin to emerge within a few weeks to a couple of months. However, the full benefit may not be realized until several weeks or even a few months of consistent use.
- Stabilization: Once the medication has reached its full therapeutic effect, you may experience more stable moods and reduced symptoms. This stabilization phase can vary but often occurs within the first two to three months.
- Long-Term Use: SSRIs may be prescribed for longer-term use, especially for individuals with chronic or recurrent conditions like depression or anxiety. Continued use of the medication may help prevent relapse of symptoms.
It's important to note that individual responses to SSRIs can differ, and your healthcare provider may need to adjust your medication dose or switch to a different SSRI if you do not respond well to the initial treatment. Elderly people may respond differently to SSRIs when compared with younger individuals.
Do antidepressant side effects go away?
When asking, “how long do SSRI side effects last?” it is important to consider that antidepressant side effects can vary widely from person to person. For many people, some side effects do diminish or go away over time as the body adjusts to the medication. Here's what you can generally expect:
Early Side Effects: In the first few days to weeks after starting an antidepressant, clinical trails show that it is common to experience side effects such as nausea, dizziness, sleep disturbances, increased anxiety, or gastrointestinal discomfort. These side effects may be temporary and gradually improve as your body adapts to the medication.
Short-Term Side Effects: Some side effects, such as sleep disturbances or increased anxiety, may persist for a few weeks but tend to subside as your body adjusts to the medication. In some cases, your healthcare provider may prescribe additional medications or recommend strategies to manage these side effects.
Long-Term Side Effects: Long-term side effects can vary depending on the specific antidepressant and the individual. Some people may experience side effects related to sexual desire, weight changes, or other ongoing side effects while taking the medication. It may be important to discuss any persistent or bothersome side effects with your healthcare provider, as they may be able to adjust the medication or suggest alternative treatments.
Individual Variability: Individual responses to antidepressants can differ. What works well for one person may not be as effective or may cause different side effects in another. It may take some trial and error to find the right antidepressant and dosage that works best for you.
Can SSRIs make you feel worse at first?
Yes, it's possible for SSRIs, which are commonly prescribed antidepressant medications, to make you feel worse or experience initial side effects when you first start taking them. This period is often referred to as the "adjustment phase," and it can last for the first few days to a few weeks after beginning treatment.
Do you go back to normal after SSRIs?
The experience of going back to "normal" after taking SSRIs (Selective Serotonin Reuptake Inhibitors) for a period of time can vary from person to person and depends on several factors, including the individual's condition, treatment response, and the reasons for taking the medication. Here are some general considerations:
- Treatment Goals: The term "normal" can mean different things to different people. In the context of antidepressant treatment, the goal is typically to alleviate or manage the symptoms of depression or anxiety and improve overall well-being. Successful treatment with SSRIs often means achieving a state of reduced or manageable symptoms and an improved quality of life.
- Duration of Treatment: The duration of SSRI treatment varies based on the individual's response and the clinical judgment of the healthcare provider. Some individuals may take SSRIs for several months or even years to maintain symptom control and prevent relapse.
- Tapering and Discontinuation: When it's time to discontinue SSRIs, it's essential to do so under the guidance of a healthcare provider. Abruptly stopping these medications can lead to withdrawal symptoms. Tapering (gradually reducing the dose) is often recommended to minimize withdrawal effects.
- Recovery and Relapse: Some individuals may experience a full recovery from depression or anxiety while taking SSRIs and may eventually discontinue the medication successfully. Others may find that discontinuing the medication leads to a return of symptoms, in which case they may need to resume treatment.
- Lifestyle and Coping Strategies: While SSRIs can be highly effective in managing symptoms, they are not the sole solution to mental health challenges. Individuals can also benefit from learning and practicing coping strategies, lifestyle changes, and therapy to maintain good mental health.
- Regular Follow-Up: After discontinuing SSRIs or reaching a stable treatment phase, individuals often have periodic follow-up appointments with their healthcare provider to monitor their mental health and make adjustments to treatment as needed.
How do I know if my SSRI is working?
You can gauge whether your SSRI (Selective Serotonin Reuptake Inhibitor) is working by paying attention to changes in your mood, thoughts, and daily functioning. Here are some indicators that your SSRI may be effective:
- Mood Improvement: If you notice a positive shift in your mood, such as feeling less persistently sad, anxious, or irritable, it may be a sign that the medication is working.
- Better Functioning: An effective SSRI can help you function better in daily life. This includes being more able to concentrate, complete tasks, maintain relationships, and engage in activities you enjoy.
- Reduction in Physical Symptoms: If you were experiencing physical symptoms related to your mental health condition, such as changes in sleep patterns or appetite, you may observe improvements in these areas.
- Overall Quality of Life: Consider whether your overall quality of life has improved since starting the SSRI. This includes factors like your ability to enjoy activities, connect with others, and experience a sense of hope and optimism.
It may be important to remember that the response to an SSRI can be gradual, and not everyone will experience immediate changes. Additionally, the effectiveness of the medication can vary from person to person. Regular communication with your healthcare provider is crucial throughout the treatment process.
Why do I still feel bad on antidepressants?
Feeling bad or not experiencing the expected improvement in mood while taking antidepressants can be frustrating and disheartening, but it's not uncommon. There are several potential reasons why you may still feel bad while taking antidepressants, including treatment timing. Antidepressants may take several weeks to reach their full therapeutic effect. During this adjustment period, you might not see immediate improvements, and you may even experience side effects. In addition, not all antidepressants work the same way, and individual responses can vary. If one antidepressant doesn't provide the desired results, your healthcare provider may need to consider trying a different medication or adjusting the dosage to experience fewer side effects.
It also may be important to consider that depression and anxiety can have various underlying causes, including biological, psychological, and environmental factors. Antidepressants primarily address the biological aspects of these conditions, so they may not fully alleviate symptoms if other factors are at play. In some cases, individuals may have treatment-resistant depression, meaning they do not respond well to multiple antidepressant medications. In such situations, alternative treatments, such as therapy, lifestyle changes, or different types of medications, may be explored.
How do I know if my SSRI is too strong?
Determining if your SSRI (Selective Serotonin Reuptake Inhibitor) dosage is too strong or not suitable for you is a decision that should be made in consultation with your healthcare provider. They will assess your symptoms, monitor your response to the medication, and consider potential side effects. However, there are some signs and symptoms that you can watch for that may suggest your SSRI dosage is too strong for your individual needs:
- Excessive Side Effects: If you are experiencing severe or intolerable side effects, such as extreme drowsiness, dizziness, nausea, or increased anxiety, it could be an indication that your SSRI dosage is too high.
- Exaggerated Emotional Blunting: While SSRI medications are designed to help manage symptoms of depression and anxiety, in some cases, they can lead to emotional blunting, where you feel numb or disconnected from your emotions. If you notice a significant loss of emotional depth or feeling overly flat or indifferent, it may be a sign that the dosage is too strong.
- Agitation or Restlessness: Some individuals may experience heightened agitation, restlessness, or jitteriness when their SSRI dosage is too high. This can manifest as increased anxiety or an inability to sit still.
- Insomnia or Sleep Disturbances: An excessively strong SSRI dosage may lead to severe sleep disturbances, making it difficult to fall asleep or stay asleep.
- Gastrointestinal Issues: Excessively high doses of an SSRI can cause or exacerbate gastrointestinal side effects, such as nausea, diarrhea, or stomach discomfort.
- Hyponatremia: Certain SSRIs can lead to a condition called hyponatremia, characterized by dangerously low sodium levels in the blood. Symptoms may include confusion, headache, muscle twitching, and, in severe cases, seizures. If you experience any of these symptoms, seek immediate medical attention.
If you believe that your SSRI is too strong it may be beneficial to consult with your doctor as too much serotonin can lead to serotonin syndrome which is a potentially life threatening condition. It is also important to follow all directions on the product labeling, especially when starting newer antidepressants, to reduce the risk of increasing serotonin too much.
Why do I feel worse on SSRIs?
Experiencing a worsening of symptoms or feeling worse when starting SSRIs (Selective Serotonin Reuptake Inhibitors) is not uncommon. Several factors contribute to this:
- The adjustment period: SSRIs typically take several weeks to show their full therapeutic effects. During this time, you may not see immediate improvements and may even experience side effects. It's crucial to be patient and allow the medication time to work.
- Initial side effects: SSRIs can cause side effects when you begin taking them, such as nausea, dizziness, insomnia, increased anxiety, and irritability. These side effects are often temporary and tend to lessen as your body adapts to the medication.
- Individual differences: Responses to SSRIs vary, and what works for one person may not be suitable for another. Your specific SSRI may not be the best fit for your needs, and your healthcare provider may consider alternative medications or dosage adjustments.
- Co-occurring conditions: Individuals with other conditions, like anxiety or bipolar disorder, may experience exacerbated symptoms when starting an SSRI. Your overall mental health should be assessed, and any co-occurring conditions considered in your treatment plan.
- Psychological factors: Concerns about side effects or anxiety related to taking medication can contribute to negative feelings. Addressing these concerns with your healthcare provider or therapist is essential.
Open communication with your healthcare provider is crucial when experiencing adverse effects or changes in your symptoms. They can provide guidance, monitor your progress, and make necessary adjustments to your treatment plan. Many individuals who initially feel worse on SSRIs find that their symptoms improve as they continue treatment and the medication takes full effect.
When should you stop SSRIs?
Deciding when to stop SSRIs (Selective Serotonin Reuptake Inhibitors) should be a carefully considered decision made in consultation with your healthcare provider. Here are some common scenarios in which SSRIs may be discontinued:
- Symptom Improvement: If you initially started taking SSRIs for the treatment of depression, anxiety, or another mental health condition, the decision to stop the medication may come when your symptoms have significantly improved, and you have experienced a sustained period of stability. Your healthcare provider will assess your progress and symptoms to determine if discontinuation is appropriate.
- Stable Remission: In some cases, individuals may achieve a state of remission, where they are free of symptoms for an extended period while taking SSRIs. Your healthcare provider may consider discontinuation if you have maintained this stable remission for a sufficient duration.
- Side Effects or Intolerance: If you experience intolerable side effects from SSRIs or if the medication is not well-tolerated, your healthcare provider may consider discontinuation or a switch from one SSRI to another. They may also try a different class of medication, such as tricyclic antidepressants or monoamine oxidase inhibitors.
- Treatment Plan Assessment: A periodic assessment of your treatment plan is essential. Your healthcare provider should review your progress and the benefits versus risks of continued SSRI use. If you and your provider believe that you have met your treatment goals or that alternative treatments may be more appropriate, discontinuation may be discussed.
- Decision-Making: The decision to stop SSRIs should always involve decision-making between you and your healthcare provider. It's essential to discuss the potential benefits and risks, as well as any concerns you have about discontinuing the medication.
- Tapering Off: If you and your healthcare provider decide to discontinue SSRIs, it's crucial to do so gradually and under medical supervision. Abruptly stopping these medications can lead to withdrawal symptoms or SSRI discontinuation syndrome. Tapering involves gradually reducing the dose over time to minimize withdrawal effects.
- Maintenance and Follow-Up: Even after discontinuation, ongoing monitoring of your mental health and any potential relapse or recurrence of symptoms is essential. Your healthcare provider should establish a plan for follow-up and continued support as needed.
Why do SSRIs cause anxiety at first?
SSRIs (Selective Serotonin Reuptake Inhibitors) can initially lead to increased anxiety or worsened anxiety symptoms for some individuals. This paradoxical effect occurs due to several factors. When SSRIs are first introduced, they boost serotonin levels in the brain, which can trigger an initial increase in neuronal activity. This heightened activity may lead to increased feelings of restlessness, agitation, and anxiety. Additionally, it can take several weeks for the therapeutic effects of SSRIs to develop, during which time the imbalance between serotonin and other neurotransmitters in the brain may contribute to anxiety symptoms. However, as the body gradually adjusts to the medication and serotonin levels stabilize, many individuals find that their anxiety symptoms begin to improve, and the overall therapeutic benefits of the SSRI become apparent.
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